de Lijster Manou S, Bergevoet Rosemarijn M, van Dalen Elvira C, Michiels Erna M C, Caron Huib N, Kremer Leontien C M, Aronson Daniel C
Pediatric Surgical Center of Amsterdam, EmmaChildren’sHospital / AcademicMedical Center, Amsterdam,Netherlands.
Cochrane Database Syst Rev. 2012 Jan 18;1:CD008403. doi: 10.1002/14651858.CD008403.pub2.
Minimally invasive surgery (MIS) is an accepted surgical technique for the treatment of a variety of benign diseases. Presently, the use of MIS in patients with cancer is progressing. However, the role of MIS in children with solid neoplasms is less clear than it is in adults. Diagnostic MIS to obtain biopsy specimens for pathology has been accepted as a technique in paediatric surgical oncology, but there is limited experience with the use of MIS for the resection of malignancies.
To ascertain the differences in outcome between the minimally invasive and open approach in the treatment of solid intra-thoracic and intra-abdominal neoplasms in children, regarding overall survival, event-free survival, port-site metastases, recurrence rate and surgical morbidity.
We searched the electronic databases of MEDLINE/PubMed (from 1966 to February 2011), EMBASE/Ovid (from 1980 to February 2011) and CENTRAL (The Cochrane Library 2011, Issue 1) with pre-specified terms. In addition, we searched reference lists of relevant articles and reviews, conference proceedings and ongoing trial databases.
Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) comparing MIS and open surgery for the treatment of solid intra-thoracic or intra-abdominal neoplasms in children (aged 0 to 18 years).
Two authors performed the study selection independently.
No studies that met the inclusion criteria of this review were identified.
AUTHORS' CONCLUSIONS: No RCTs or CCTs evaluating MIS in the treatment of solid intra-thoracic or intra-abdominal neoplasms in children could be identified, therefore no definitive conclusions could be made about the effects of MIS in these patients. Based on the currently available evidence we are not able to give recommendations for the use of MIS in the treatment of solid intra-thoracic or intra-abdominal neoplasms in children. More high quality studies (RCTs and/or CCTs) are needed. To accomplish this, centres specialising in MIS in children should collaborate.
微创手术（MIS）是治疗多种良性疾病的一种公认的手术技术。目前，MIS在癌症患者中的应用正在发展。然而，MIS在实体肿瘤患儿中的作用不如在成人中明确。诊断性MIS获取病理活检标本已被儿科外科肿瘤学接受为一种技术，但MIS用于恶性肿瘤切除的经验有限。
确定在治疗儿童胸内和腹内实体肿瘤时，微创手术与开放手术在总生存、无事件生存、切口转移、复发率和手术并发症方面的结局差异。
我们使用预先设定的检索词，检索了MEDLINE/PubMed（1966年至2011年2月）、EMBASE/Ovid（1980年至2011年2月）和CENTRAL（Cochrane图书馆2011年第1期）的电子数据库。此外，我们还检索了相关文章和综述的参考文献列表、会议论文集和正在进行的试验数据库。
比较MIS与开放手术治疗儿童（0至18岁）胸内或腹内实体肿瘤的随机对照试验（RCT）或对照临床试验（CCT）。
两名作者独立进行研究筛选。
未找到符合本综述纳入标准的研究。
未找到评估MIS治疗儿童胸内或腹内实体肿瘤的RCT或CCT，因此无法就MIS对这些患者的影响得出明确结论。基于目前可得的证据，我们无法对MIS用于治疗儿童胸内或腹内实体肿瘤给出建议。需要更多高质量的研究（RCT和/或CCT）。为此，专注于儿童MIS的中心应开展合作。
